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APPLICATION - SITE APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> Other <br /> Describe any items of historical or archaeological interest on-site (e.g. cemeteries or structures): <br /> None noted <br /> Describe any on-site or off-site sources of noise or vibration(e.g. freeway noise, heavy equipment, etc.), <br /> Backup generator and A/C units. <br /> Describe any on-site or off-site sources of light of glare(e.g. parking lot lighting,or reflective materials used). <br /> None <br /> Describe any on-site or off-site source of odor(e.g. agricultural wastes): <br /> None <br /> Describe any displacement of people that will be caused by the project(e g. numbers of people. housing units), <br /> �None <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents. officers and <br /> employees from any claim, action or proceeding against the Owner/Agent's project. <br /> 1, further, certify under penalty of perjury that I am (check one) I} <br /> ❑ Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> Involved in this application, or <br /> Legal agent (attach proof of the owner's consent to the application of the property's involved in this <br /> application and have been authorized to file on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> Print Name- 4A Signature: Date:_ <br /> Print Name: Signature76Date:__­- <br /> Print Name: Signature. Date: <br /> Print Name: Signature: Date: <br /> Print Name, Signature: .... ........ Date: <br /> F%0EVSVCR1annsng Application Forrris\Sae Approval.(Revised 6-W-04) Page 5 of 9 <br />